Kelly Murphy has been the PACS administrator at Baylor Medical Center at Garland (Tex.) since the hospital installed its GE Centricity PACS in November 2001. Murphy, in conjunction with a host of vendor and professional partners, has truly charted a PACS success story. This month, Health Imaging & IT tracked Murphy to find out just what a day in the life of PACS administrator entails.
EARLY TO RISE
Murphy's day begins early. The former nuclear medicine technologist arrives at the hospital before 7:30 a.m. and starts the day by logging onto the RIS email to check for any problems that occurred during the night or weekend shifts. He spends 15 minutes responding to and repairing PACS users' issues.
"Most days I don't have to spend a lot of time on these early morning problems like exam and patient merges, workstation lockups, peripheral device malfunctions, damaged CR cassettes and error messages because I have a great weekend supervisor and a good night staff," Murphy explains.
At 8:00am, Murphy is entrenched in the PACS database and completely focused on ferreting out errors. Before long, the phone rings. It's a radiologist with an error message in the workflow cycle. Murphy leaves his office to meet with the radiologist and attempt to repeat and solve the error message. Today is a good day. A member of the hospital IT team is able to join Murphy, and the pair duplicates and resolves the error in about an hour and a half. Some days Murphy spends the majority of the day trying to reproduce an intermittent error, without success. Often the errors are linked to corrupt hanging protocols.
At 9:45am, Murphy returns to the database to work on a troublesome CT exam. After some QA checks and a couple of phone calls, Murphy discovers a CT technologist placed images on the wrong radiology order. He spends the next hour working with the RIS manager to generate a new order, credit the incorrect charges and merge the images into the good order.
Murphy is quick to point out that a successful PACS cannot rely on a single individual; some PACS fixes must come from outside the local PACS team. Murphy draws from the experience and expertise of a variety of sources, including the modality and PACS vendors' field support teams. Murphy also scans PACS users websites, such as ClubPACS or Aunt Minnie's bulletin boards and a variety of online PACS user groups, for additional insight into a particular issue. "PACS administrators are a pretty sympathetic bunch," Murphy says. "They're usually willing to help a fellow PACS admin, especially when they've gone through a similar scenario."
It's Wednesday, Murphy's weekly QA day. Before turning to weekly tasks, Murphy strolls down to radiology to put out yet another fire. This call is a quick one; he checks in with a technologist who called about a black box artifact on an image. Murphy resolves the problem by making a cursor configuration change on the workstation that was recommended in the PACS vendor's most recent software release notes.
Murphy confesses, "I have remote access to the entire system from my office, and I could troubleshoot 90 to 95 percent of the problems from my desk. I find it really helpful to listen to and talk with users live; I can get so much more information from a conversation than I can from an email or voicemail. This helps me fix the problems and gives our users confidence that there is someone here to listen to them and take care of problems."
Murphy almost always takes the time to meet with the user if there is an image display issue so he can see what the user sees. Generally, a reboot of the workstation solves the problem, but the user may not report the next problem if he reboots the PC remotely. Murphy sums, "I need to know all of the issues for trending and reporting purposes. I want users to call me about PACS issues."
Murphy trots back to his desk, checks email and finds that he needs to investigate an error message in the Archive Retrieval queue before he can jump into QA. A radiologist has a comparison study stuck in transition from the long-term archive to the short-term, online archive. He logs a call into the PACS vendor's online support center. Within 45 minutes, the exam is back online and ready for the radiologist.
Murphy comes to a good stopping point on the weekly QA with a few minutes to spare before the next meeting. He browses through a couple of PACS and IT journals looking for innovative ideas to improve workflow or troubleshooting.